9 december 2010: Bron: Medscape

Wanneer patienten met ALL - acute lymfatische leukemie (Philadelphia) vooraf aan een stamceltransplantatie Gleevec kijrgen dan hebben deze significant meer kans op langere ziektevrije tijd en significant meer kans om de ziekte te overleven. 40% bleek uiteindelijk de ziekte te overwinnen met deze combinatiebehandeling. Dit blijkt uit een nieuwe studie uitgevoerd in Engeland en gepresenteerd op een symposium voor hematologie. Hier de studieresultaten uit een artikel uit Medscape. Volledige artikel is hier te lezen.

December 5, 2010 (Orlando, Florida) — Early use of imatinib (Gleevec; Novartis) during induction for Philadelphia + (Ph+) acute lymphoblastic leukemia (ALL) can significantly enhance transplantation outcomes, according to data reported here at the American Society of Hematology 52nd Annual Meeting.

Imatinib significantly enhanced complete response rates and increased the allogeneic hematopoietic stem cell transplant (alloHSCT) rate. The authors note that in turn, these effects translate into a highly significant event-free, relapse-free, and overall survival advantage.

Before the use of imatinib, only 28% of patients went on to receive alloHSCT as per protocol. However, that number has risen to 44% with imatinib.

Overall survival at 3 years for patients who received per protocol alloHSCT was 59% compared with 28% for those who were not transplanted. However, before imatinib, the 5-year overall survival rate was 40% for those who received transplants vs 19% for nontransplanted patients.

Survival Advantages Observed

The researchers found that among patients who did not receive imatinib, overall survival reached 25%. This was compared with 34% in the Late Imatinib group and 48% in the Early Imatinib group.

Similar results were seen for event-free survival: 19% in the pre-imatinib group, 29% in the Late Imatinib group, and 35% in the Early Imatinib group. For relapse-free survival, the percentages were 36%, 45%, and 62%, respectively. The 3 groups were similar in terms of white blood cell counts and the presence of central nervous system disease at diagnosis, although the pre-imatinib cohort was younger as a result of an increase in the upper age limit for study entry.

An earlier start to imatinib is significantly better than a later start, the authors conclude, and there "can be no basis for omitting imatinib from the initial therapy of adult patients with Ph+ ALL."

The data show, however, that the best outcome is observed when patients receive imatinib followed by myeloablative alloHSCT, the researchers note. In this case, nearly 60% of such patients survive 3 years from diagnosis.

American Society of Hematology 52nd Annual Meeting: Abstract 169. Presented December 5, 2010.


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